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Involving
fathers in kids ADHD treatment programs

While working with parents of children with attention deficit
hyperactivity disorder (ADHD) at UB, Greg Fabiano noticed something was
missing: the fathers.

Soccer games, like this one at
last years Summer Treatment Program, are a key component of the
COACHES program designed to increase fathers participation in
their childrens ADHD treatment.PHOTO: JOHN DELLACONTRADA

Fabiano, an assistant professor in the Graduate School of Education,
made the discovery while still a graduate assistant at the UB Center for
Children and Families, which runs a summer treatment program that has
helped more than 2,500 children with behavioral, emotional and learning
problems. The program uses sports as a way to teach children
peer-relationship skills, Fabiano said.

"I knew a lot of the dads
in that program because they would show up early to watch their kids on
the soccer fields or the softball fields and we'd chat it up when we
were out there," recalled Fabiano, who teaches in the Department of
Counseling, School and Educational Psychology.

"But then they
would take their child and go home in the one car, and then the mom
would drive up in another car and go to the parenting group," he added.
"I thought 'There is something wrong with this picture.'"

To
find out why fathers of children with ADHD weren't participating in
treatment programs, or why some initially participate, but then drop out
soon after, Fabiano turned to research literature on the subject and
found...nothing.

"I was surprised to find there were no studies
on dads with kids with ADHD and so I thought this would be a good area
in which we could try to do something. My dissertation was trying out a
parenting program specifically for fathers, using sports as a kind of
hook to get the dads interested and the kids, too," Fabiano said.

His new research program, designed for children 6-12 years of age,
includes two formats: a control group of fathers and children who
receive traditional, evidence-based treatments for ADHD families and
another group that receives the same, plus a sports elementin this
case, soccer games. This second group is dubbed COACHES, or Coaching Our
Acting-Out Children: Heightening Essential Skills.

Traditional
treatments include teaching parents strategies to deal with the
disruptive behaviors that are hallmarks of the disorder. Adding the
COACHES element, Fabiano hoped, would result in increased participation
for the fathers and improved relationships with their children.

"We thought for a chronic disorder like ADHDwhere these fathers
aren't going to be dealing with these problems for a couple weeks or a
couple months, but for the child's entire lifethe treatment has to
be well-liked, palatable and engaging," Fabiano explained.

The
results, he said, have been remarkable.

"We had huge differences
on things like drop-out rates for both the dad and the child. The dads
in the COACHES group were more likely to try out the homework, which was
a pretty big accomplishment," Fabiano said. "They also rated the
treatment as better."

Another surprise was the lack of tension
between fathers and players, and between the fathers themselves, when it
came to controversies on the playing field.

"We were a little
nervous about the dads because you read the newspaper and you see
fathers getting into fights with the referee. But we have not had that.
The dads seem to be genuinely enjoying the activities, perhaps because
the children have struggled in other settings and are successful in this
one," Fabiano said.

Also, the children themselves seemed to be
tension-free while playing, a sharp contrast to their previous
experiences with sports, he said.

"Families with children with
ADHD tell us lots of horror stories about their children failing at team
sports because they weren't paying attention when the ball is coming
toward them or they have a low frustration threshold, so they stomped
off the field if they made an error," Fabiano said.

The best
result by far was the sense of community that the program offered the
fathers.

"In groups, the dads said things like 'I didn't realize
other dads had kids like this,' so there is a sense of isolation among
these parents. Maybe putting fathers together who have children
challenged in sports takes things in a positive direction, as opposed to
a negative direction that makes a father defensive because he sees his
child struggling when other kids aren't," Fabiano said.

At each
meeting, while the children practice soccer skills, the fathers meet to
learn parenting skills, such as "how to pay attention to the child's
good behaviors, give clear commands, use time outs well," Fabiano said.

Now recruiting families for another session of COACHES funded by
the National Institute of Mental Health, Fabiano said the program will
stick with soccer for now because "it spreads the kids out so the dads
can get right out on the field and monitor their kids very well. There's
also lots of action, unlike baseball, where you might be standing by
yourself for 20 minutes and not have anything come your way."

Success on the field means a greater chance of success at home and
school.

"Soccer engages the kids, who we want to be behaving
well when the parents are trying out new skills. We don't want parents
trying out a skill during a child's most difficult-to-manage behavior,"
he said. "If they succeed, they are more likely to try it out at home,
when the kids are doing homework or are supposed to clean their
rooms."

For more information about the COACHES and other
treatment programs available to families of children with ADHD, call
829-2244, ext. 124, or visit the Center for Children and Families Web site.